What Surgery Means for Trans Folk, Part 2

To Cut or Not to Cut

Me, at Olbrich Botanical Gardens, 2 weeks post-surgery.

As I noted in my last post, surgery doesn’t make the trans person. Nor do a psych eval, therapy, or an endocrinologist versed in trans care. Though not required, they helped me on an 18-month journey to surgery in which I learned even more about myself, body, heart, and mind. I took 50 years to realize I'm trans. Every day since my surgery two years ago has been a continued blossoming.

I took 50 years to realize I'm trans. Every day since my surgery two years ago has been a continued blossoming.

Impact of HRT

Sixth months into transition, I started hormone replacement therapy (HRT). Pundits blather about HRT's physical effects but miss its most profound impact—the mental and emotional balance it brings. After a week of estradiol and testosterone blockers, I asked Pam, “Is this what life is really like? No gnawing anxiety, no numbing depression? No constant vigilance of my status, behavior, and presentation? No eternally simmering anger?”

Gone was the nameless regret I’d always felt. In its place came compassion—for myself and others. The simmering anger was replaced with an empathy and forbearance that had been sapped by decades of putting up with myself.

I felt a peace and joy that all would proceed as it was meant to.

The Surgery I Chose

Months of research into more than 50 providers in the U.S. and abroad led to a call from Dr. Katherine Gast at the University of Wisconsin Health in Madison to confirm my surgery. Though the procedure would not be for another four months, I felt a peace and joy that all would proceed as it was meant to.


My biggest decision came down came down to practical considerations. I chose vulvoplasty (also known as minimal-depth vaginoplasty) because:

  • I was pleased with the effects of HRT on my face, breasts, and weight distribution—so, no face or other body-based procedures.

  • Though I wanted my genitalia to match my identity as a woman, I had no interest whatsoever in receptive-penetrative sex. Vulvoplasty answered well as it creates a fully functional vulva without a vaginal canal.

I had no expectations for surgery other than that it was the right thing to do.

Surgery and Recovery

Gender confirmation surgery is like any other procedure requiring general anesthesia. One minute I was talking to Dr. Gast in the prep area, next thing, I woke in my hospital room. Recovery pain was not an issue, and I didn't take any of the morphine tablets prescribed for me once we got back to the AirBnB. After a week, my surgical drain was removed, and for the next four weeks, I wore mini-pads for spotting and sat delicately on a donut pillow. I had to pace myself, listening to my body when it told me to rest. For a time, I thought I'd always bear a scar but two years post-surgery, the area shows no mark.


So, Did It Work?

Did surgery do what I expected? Well, I had no expectations for it other than that it was the right thing to do. I feel at home in my body in a way I didn't previously. I love how I feel, how I look, how I am.


As for who I am … I'm me. Surgery didn't do that, but, like HRT, it's delivered a balance, wholeness, and sense of fulfillment I didn't before experience. My very flesh matches who I know myself to be. I didn't need doctors, hormones, or procedures to be the woman I've always been, but they've helped me live as the person I always knew I was, but couldn't touch.


I wasn't altered. I'm healed.

Let's just say that I'm a very happy bit of lady.

Coda—No, I Mean, Does It Work?

I know, I know—you wanna hear whether it works in terms of sexual function. If you didn't learn in Bio or Sex Ed how lady bits work, then you have to ask a woman in your life who's comfortable answering such queries. Let's just say that I'm a very happy bit of lady.

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